<Date>

<Member Name>

<Member Address>

Dear <AUTHORIZED REPRESENTATIVE NAME>:

«PatientFullName» is enrolled in HealthPartners Minnesota Senior Health Options (MSHO). I am a HealthPartners MSHO Care Coordinator. I recently met with «PatientFullName» and facility staff to complete a health assessment. Based on this assessment, a care plan was developed. It is included for your review.

Our goal is to make sure that the patient’s care needs are being met. This includes supporting the patient’s return to the community when needed.

In addition to directly supporting the patient, we help support the doctors, nurses and other care professionals who are caring for <Member Name>. We may participate in care conferences and help access plan benefits or other community resources that are needed.

HealthPartners MSHO plan benefits include medical and dental benefits. Please contact Member Services for other benefit information. You can call RideCare at (952) 883-7400 for rides to and from medical and dental appointments. The Behavioral Health Navigators are available to assist members in choosing Behavioral Health providers by calling (952) 883-5811.

Feel free to contact me with any questions or concerns.

Sincerely,

«CaseOwnerFullName»

MSHO Care Coordinator

HealthPartners Case Management

Enclosures: 1 care plan, MSHO Integrated Appeal Rights, Statement of Nondiscrimination for Health Plan Members, Language Block

HealthPartners is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in HealthPartners depends on contract renewal.

H2422_87795 Ad Hoc 03/09/2015